GI Special Studies
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| Endoscopy benefit | both diagnostic and therapeutic
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| Risks of GI endoscopy | perforation, bleeding, infection,cardiopulmonary complications secondary to sedation,death
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| upper endoscopy (gastroscope); allows visualization of esophagus, stomach and duodenum | Esophagogastroduodenoscopy (EGD)
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| examines descending colon, sigmoid colon and rectum | Flexible sigmoidoscopy
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| Visualization of entire colon | Colonoscopy
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| “push” endoscopy of small bowel | Enteroscopy
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| combines endoscopy and radiography to image pancreatic and biliary ducts | Endoscopic retrograde cholangiopancreatography (ERCP)
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| video capsule endoscopy | esophagus, small bowel visualization
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| ___ allows transluminal imaging | endoscopic ultrasound
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| ____ is very useful for patients with inflammatory diarrhea who need view of distal colon only. It has limited use now. | Flex Sigmoidoscopy
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| allows visualization of entire colon and portion of terminal ileum | Colonoscopy. Patients are out for this procedure.
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| Prior to colonoscopy... | requires extensive bowel preparation + liquid diet for 24 hours prior to procedure
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| now regarded as study of choice for staging of rectal, esophageal and gastric tumors and identification of pancreatic tumors | Endoscopic Ultrasound (EUS)
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| If suspicious of crohn's, but didn't see anything on endoscopy, go to | PILL CAM SB
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| gold standard for visualizing small bowel | Video capsule endoscopy
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| When should VCE's be avoided? | avoid in patients with GI distress, fistulas, pregnancy or swallowing disorders. this is not biodegradable, and if it is not passed, it needs to be retrieved!
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| Virtual colonoscopy refers to | CT or MRI colonoscopy. 2D. Still requires bowel prep. In MRI, patients aren't exposed to ionizing radiation. Unable to detect lesions <5mm
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| Gold standard evaluation of liver disease | liver biopsy. Ex: standard of care in patients with hep. C. helps you stage and treat appropriately.
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| Most favored way to obtain liver biopsy | percutaneous. Want specimen to be a portal triad (vein, nerve and artery). Specimen size 1.5cm long and 2mm wide
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| Indications for Liver Biopsy | evaluation of abnormal LFTs, suspected neoplasm, confirmation of diagnosis(hep. c, primary biliary cirrhosis, alcoholic cirrhosis, non-alcoholic fatty liver dsz(NASH)). evaluate granulomatous dz, unexplained jaundice or drug rxn. Manage post transplant
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